Local treatment of toxoplasmic retinochoroiditis with intravitreal clindamycin and dexamethasone

Arquivos Brasileiros de Oftalmologia

Yuslay Fernández Zamora¹  Tiago Arantes¹  Frederico Augusto Reis¹  Claudio Renato Garcia¹  Janaína Jamile Ferreira Saraceno¹  Rubens Belfort Jr.¹  Cristina Muccioli¹ 

关键词: Chorioretinitis/drug therapy;    Toxoplasmosis;    ocular;    Intravitreal injections;    Clindamycin/administration and dosage;    Dexamethasone/administration and dosage;    Coriorretinite/quimioterapia;    Toxoplasmose ocular;    Injeções intravítreas;    Clindamicina/administração & dosagem;    Dexametasona /administração & dosagem;   

DOI  :  10.5935/0004-2749.20150056

来源: SciELO

【 摘 要 】

ABSTRACTPurpose:To report the clinical outcomes of local treatment of toxoplasmic retinochoroiditis (TRC) with intravitreal injections of clindamycin and dexamethasone.Methods:Study population: 16 eyes (16 patients) with active TRC sparing the macula and juxtapapillary area treated with intravitreal injections of clindamycin (1 mg) and dexamethasone (1 mg) without concomitant systemic antitoxoplasmic or anti-inflammatory therapy. Measured parameters: Best-corrected visual acuity (BCVA) was measured by an Early Treatment Diabetic Retinopathy Study (ETDRS) chart. BCVA and clinical characteristics of retinochoroiditis were assessed at baseline and at 1, 3, 6, and 12 months. Primary outcome measures: Resolution of retinochoroiditis and changes in BCVA.Results:Control of TRC was achieved in all cases with a mean interval of 2.48 ± 1.03 weeks (2-6 weeks). A single injection of intravitreal clindamycin and dexamethasone was performed in 12 patients, and four patients required two intravitreal injections, during the follow-up period. Fourteen eyes (87.5%) improved ≥ 2 ETDRS lines of BCVA, of two or more Early Treatment Diabetic Retinopathy Study lines, BCVA remained stable in two eyes (12.5%), and no patient had decreased BCVA at the end of the follow-up period. No ocular or systemic adverse events were observed.Conclusion:Local treatment with intravitreal injections of clindamycin and dexamethasone without concomitant systemic therapy was associated with resolution of TRC in patients without macular or juxtapapillary involvement. Intravitreal clindamycin and dexamethasone may represent a viable treatment option in patients with allergies or inadequate responses to oral medications.

【 授权许可】

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